Map of life expectancy at birth from Global Education Project.

Thursday, April 30, 2020

The Death Cult

So Georgia Governor (by electoral fraud) Brian Kemp was listening to the deranged ravings of his Dear Leader on the Teevee and picked up that it was time to liberate Georgia. He had a phone conversation with Dear Leader and got the go ahead. So he announced that he was going to open up the state in the most responsible way, by first allowing barber shops, hair salons, bowling alleys and massage parlors to open on Friday -- I mean, what could be more conducive to social distancing than a massage, amirite? Then restaurants and bars on Monday. Whereupon Dear Leader announced that he didn't think that was such a great idea, since himself might be blamed for the consequences.

Of course, Kemp isn't going to let anybody anywhere near his own self and his own family. But that's okay, the trends in the data show that it's perfectly safe. Wanna see? (Credit to the New York Times.)

Hmm. Looks like the epidemic in George is over except for the complete flat, or possibly increasing daily death rate. But 40 dead Georgians a day obviously isn't enough.

So what does it really mean to reopen all these businesses? Mostly it means that employees who don't want to go back to work won't be able to continue to collect unemployment benefits. So they can choose between the risk of choking to death or starving to death. That's Freedom of Choice if I ever saw it!

Funny thing though (haha). Once that line starts up, which we'll likely see in two or three weeks, after the hospitals start filling up, Mr. Kemp is going to have a problem. It's called reality. But the chance that Republicans will ever start living in reality again appears increasingly remote.

Wednesday, April 29, 2020

What happened to me

I've been getting comments accusing me of "partisanship". Do yuh think?

Over the years, it is true, I have written on a variety of issues, often fairly wonky explications of health care or public health policy issues, explanations for lay people of technical or scientific problems, political and social philosophy, history, and more.

Lately it is true I have done a lot of posts decrying the current White House occupant and the political party which has become a cult of personality centered on the same malignant, moronic, narcissistic psychopathic clown. That the reins of power in the world's wealthiest and most powerful nation are held by a deranged idiot is indeed the greatest crisis facing humanity, in the midst of the fundamental crises we already face -- environmental degradation and climate change, resource depletion, and pandemics of novel diseases, not to mention the continuing capability of the U.S. and several other nations to destroy civilization with nuclear weapons.

The Republican Party denies the reality of all of these crises. It exists only to further enrich plutocrats and remove all constraints on their action. Since these policies are not actually popular, it bamboozles its supporters with appeals to racism, tribalism, and an endless torrent of lies.

So am I partisan? Yes, the Republican party is a cancer on humanity, and it must be utterly and forever destroyed. I hereby yield the floor to Fintan O'Toole.

It is one thing to be powerless in the face of a natural disaster, quite another to watch vast power being squandered in real time – wilfully, malevolently, vindictively. It is one thing for governments to fail (as, in one degree or another, most governments did), quite another to watch a ruler and his supporters actively spread a deadly virus. Trump, his party and Rupert Murdoch’s Fox News became vectors of the pestilence.
The grotesque spectacle of the president openly inciting people (some of them armed) to take to the streets to oppose the restrictions that save lives is the manifestation of a political death wish. What are supposed to be daily briefings on the crisis, demonstrative of national unity in the face of a shared challenge, have been used by Trump merely to sow confusion and division. They provide a recurring horror show in which all the neuroses that haunt the American subconscious dance naked on live TV.

Sunday, April 26, 2020

At last we know the truth!

I got this e-mail today. Unfortunately the attachments are entirely in Chinese, so I can't read them. This is extremely frustrating because I would really like to know what is actually going on, since what appears to be happening can't possibly be real. If anyone can translate from Chinese let me know and I'll forward the truth to you.

The truth behind the new crown virus and the deduction of the actual war of the Third World War


World Sciences

Attachments4:55 AM (3 hours ago)


experts and scholars:   

    The content in the attachment is provided to you by the dean of the World Academy of Sciences, superpowered scientists, 
the final review member of the Prophet International Union Cult Appraisal Committee,The double-edged sword in Revelation Bible prophecy --- King Kong Prophet Su Beijian, and the Prophet International Union International Strategic Think Tank,
Include "Virus 911 Truth", "the deduction of the actual war of the Third World War", so that you can understand the facts of the new crown virus, as well as important information related to everyone's future, the details are in the attachment

    Yours truly,
    The Prophet International Union

Sunday Sermonette: Fashion Disaster

The literal and inerrant word of God keeps getting weirder and more errant, at least to anyone with common sense. Whatever may have inspired the preceding obsession with pimples or boils or carbuncles or whatever exactly was going on, at least those afflictions exist. People do get various dermatological lesions, although modern physicians do not prescribe rending your garments, covering your upper lip, moving out into the desert and crying "Unclean! Unclean!"

What we are about to read, however, defies explanation. I have not been able to find even speculation about what phenomenon in reality may have inspired this. It's just completely nuts. I mean sure, there could be mold or mildew on a garment, although that seems unlikely in an arid climate, but why not just wash it?

47 “When there is a leprous disease in a garment, whether a woolen or a linen garment, 48 in warp or woof of linen or wool, or in a skin or in anything made of skin, 49 if the disease shows greenish or reddish in the garment, whether in warp or woof or in skin or in anything made of skin, it is a leprous disease and shall be shown to the priest. 50 And the priest shall examine the disease, and shut up that which has the disease for seven days; 51 then he shall examine the disease on the seventh day. If the disease has spread in the garment, in warp or woof, or in the skin, whatever be the use of the skin, the disease is a malignant leprosy; it is unclean. 52 And he shall burn the garment, whether diseased in warp or woof, woolen or linen, or anything of skin, for it is a malignant leprosy; it shall be burned in the fire.
53 “And if the priest examines, and the disease has not spread in the garment in warp or woof or in anything of skin, 54 then the priest shall command that they wash the thing in which is the disease, and he shall shut it up seven days more; 55 and the priest shall examine the diseased thing after it has been washed. And if the diseased spot has not changed color, though the disease has not spread, it is unclean; you shall burn it in the fire, whether the leprous spot is on the back or on the front.
56 “But if the priest examines, and the disease is dim after it is washed, he shall tear the spot out of the garment or the skin or the warp or woof; 57 then if it appears again in the garment, in warp or woof, or in anything of skin, it is spreading; you shall burn with fire that in which is the disease. 58 But the garment, warp or woof, or anything of skin from which the disease departs when you have washed it, shall then be washed a second time, and be clean.”
59 This is the law for a leprous disease in a garment of wool or linen, either in warp or woof, or in anything of skin, to decide whether it is clean or unclean.

Friday, April 24, 2020

Beyond the edge of the stupidverse

What can I possibly add? When the maker of Lysol has to issue a public statement that, under no circumstances should its product be introduced into the human body, whether by ingestion or injection, and this statement is for a time the front page headline on CNN, we are in a waking nightmare.

Well, I do have something to add. Dr. Birx sat there, looking like she was dying inside, but she said nothing. The New York Times report reads, and I quote: "At a White House briefing, President Trump theorized — dangerously, in the view of some experts — about the powers of sunlight, ultraviolet light and household disinfectants to kill the coronavirus." What do the other experts think, Mr. Baquet? Senator McConnell, do you have a view about this? Secretary Azar? Mr. Vice President?

We have an insane idiot occupying the office of the president of the United States who is literally killing people. And every single person in a position to do anything about it is a sniveling, worthless coward. This situation has been a desperate emergency since November of 2016 and right now we're about to hit the ground from a thousand foot fall and splatter like paint. And Dr. Birx just sits there.

Thursday, April 23, 2020

Scientists and policymakers

Angela Merkel, the German chancellor, has a doctorate in molecular quantum mechanics. That makes her quite unusual among political leaders. But being a qualified quantum mechanic per se doesn't make her especially qualified to lead the German government, since molecular quantum mechanics rarely has much role informing policy.

It does mean, however, that she is what I will call scientifically literate. Very few scientists in fact know anything to speak of about molecular quantum mechanics. I understand vaguely that it's about the physics underlying chemical reactions, and that's probably as much as most physicists know, actually. I'm guessing that chemists tends to know more, but the point is that as our understanding of the world has deepened, science has become highly specialized. Being an expert in one scientific field doesn't mean you necessarily know bupkis about most others.

However, what you do know is how scientific claims are evaluated, and you likely at least have a broad grasp of how various fields of science fit together and build up a coherent picture of the world. You understand how chemistry rests on physics, how biology rests on chemistry, how psychology and society emerge from biology. You understand how physics and chemistry are essential to astronomy and cosmology, and how geology emerges from cosmic history, shaped by physics, chemistry and biology. And anyone who understands high school physics can understand how increasing carbon dioxide in the atmosphere causes the lower atmosphere and the oceans to warm.

You also understand the processes by which scientific theories are developed, tested, and come to be accepted. You understand the institutions that guard the integrity of science. They don't always do so successfully, but in the long run fraud and error gets corrected.

You don't have to be a scientist too be scientifically literate in the ways I have just described. But to be a policy maker or political leader who I can respect, you do need to be scientifically literate and you need to respect the expertise of people who have earned it. That is why I cannot respect a political party that denies the reality of anthropogenic climate change, wants to teach creationism to school children, denies that particulate pollution kills people, and continues to claim that cutting taxes on wealthy people benefits working people, among other manifest falsehoods.

I'll say it again. Reality has a well-known liberal bias. The reason is that nowadays, what distinguishes liberalism from conservatism is truth.

Tuesday, April 21, 2020

The party of delusion

I won't try to argue about the true ideology or goals of the modern conservative movement in this post. I certainly have plenty to say about that but I want to make a point cleanly here. Whatever else you may think about conservatism, it is infested with delusion. As Stephen Colbert said, reality has a well-known liberal bias, and it has never been more clear. I'll refer you first to Krugthulu, who runs down a list of quacks, con artists and wack jobs who have featured prominently on Fox News and in White House counsel. When Anthony Fauci wasn't telling them what they wanted to hear, they turned to Dr. Phil. Then there is the beyond absurd Richard Epstein whose confident prediction that the death toll in the U.S. from Covid-19 would be less than 500 in the absence of any protective measures, a prediction which strongly informed the administration's dismissive attitude toward the epidemic for February and most of March.

Then there is the stupidest member of congress, which is saying something, Louis Gohmert, who claims that doctors in Germany are passing through a magic misting chamber that renders them immune for two weeks. Anyway, the question of whether this highly transmissible virus will cause an explosive epidemic and overwhelm the health care system if left unchecked is not a matter of conservative versus liberal opinion. It is a question of what has already actually happened in Wuhan, Lombardy and New York. But the only discernible ideology of the Republican Party right now is that you have to suck up to Donald J. Trump, so Georgia Governor-by-electoral-fraud Brian Kemp is announcing the opening of hair salons, gyms, tattoo parlors and yes, massage parlors. I don't see why it's hard to maintain social distancing in a massage parlor. He plans to reopen restaurants and theaters on Monday.

I fear that Governor Kemp is going to encounter a phenomenon as yet unfamiliar to him, reality. And he will discover that it does indeed have a liberal bias.

Sunday, April 19, 2020

Sunday Sermonette: The Diagnostic and Statistical Manual of Skin Diseases

For those who claim that the Bible is the literal and inerrant word of God, and who claim to live by the Bible, Leviticus 13 and 14 ought to pose a considerable problem. Of course nobody who makes that claim is sincere. They just skip the embarrassing parts. Noah's ark is a fun story with animals. You can build a theme park around it. These chapters, however, are just deeply weird.

It's important to note that "leprosy" here does not mean the disease which has been given that name in modern times, now more properly called Hansen's Disease. None of the symptoms described here correspond to those of Hansen's disease, or at least not clearly enough to be useful for diagnosis. (The early symptoms of Hansen's disease include flat patches that may be lighter than the surrounding skin; nodules on the skin; and swelling or lumps on the face or earlobes. They do not include hair whitening.) Of course many of the most important and potentially deadly contagious diseases have dermatological manifestations: smallpox, measles, chickenpox, rubella. But you don't need a priest to recognize these and none of the symptoms described here correspond to any of them. Rather these seem to be presentations of single lesions, that might be pimples, boils, ulcers or carbuncles. These are generally not contagious. But the descriptions don't really correspond to anything in particular.

And there is the very strange outcome of the affliction covering the person's entire body, whereupon they are pronounced clean. As with most of this sort of material, I have read commentaries that try to interpret it in some metaphorical way or otherwise justify it, but I haven't read any serious attempt to explain how this got into the Torah. As I said last week, these are the longest chapters in the Bible. This stuff must be very important! So I'm going to have to split them up. Don't scratch it!

13 The Lord said to Moses and Aaron, “When a man has on the skin of his body a swelling or an eruption or a spot, and it turns into a leprous disease on the skin of his body, then he shall be brought to Aaron the priest or to one of his sons the priests, and the priest shall examine the diseased spot on the skin of his body; and if the hair in the diseased spot has turned white and the disease appears to be deeper than the skin of his body, it is a leprous disease; when the priest has examined him he shall pronounce him unclean. But if the spot is white in the skin of his body, and appears no deeper than the skin, and the hair in it has not turned white, the priest shall shut up the diseased person for seven days; and the priest shall examine him on the seventh day, and if in his eyes the disease is checked and the disease has not spread in the skin, then the priest shall shut him up seven days more; and the priest shall examine him again on the seventh day, and if the diseased spot is dim and the disease has not spread in the skin, then the priest shall pronounce him clean; it is only an eruption; and he shall wash his clothes, and be clean. But if the eruption spreads in the skin, after he has shown himself to the priest for his cleansing, he shall appear again before the priest; and the priest shall make an examination, and if the eruption has spread in the skin, then the priest shall pronounce him unclean; it is leprosy.
“When a man is afflicted with leprosy, he shall be brought to the priest; 10 and the priest shall make an examination, and if there is a white swelling in the skin, which has turned the hair white, and there is quick raw flesh in the swelling, 11 it is a chronic leprosy in the skin of his body, and the priest shall pronounce him unclean; he shall not shut him up, for he is unclean. 12 And if the leprosy breaks out in the skin, so that the leprosy covers all the skin of the diseased person from head to foot, so far as the priest can see, 13 then the priest shall make an examination, and if the leprosy has covered all his body, he shall pronounce him clean of the disease; it has all turned white, and he is clean. 14 
Now, smallpox or measles would cover all of the body, but it would not turn white.  And those diseases really are contagious.
But when raw flesh appears on him, he shall be unclean. 15 And the priest shall examine the raw flesh, and pronounce him unclean; raw flesh is unclean, for it is leprosy. 16 But if the raw flesh turns again and is changed to white, then he shall come to the priest, 17 and the priest shall examine him, and if the disease has turned white, then the priest shall pronounce the diseased person clean; he is clean.
18 “And when there is in the skin of one’s body a boil that has healed, 19 and in the place of the boil there comes a white swelling or a reddish-white spot, then it shall be shown to the priest; 20 and the priest shall make an examination, and if it appears deeper than the skin and its hair has turned white, then the priest shall pronounce him unclean; it is the disease of leprosy, it has broken out in the boil. 21 But if the priest examines it, and the hair on it is not white and it is not deeper than the skin, but is dim, then the priest shall shut him up seven days; 22 and if it spreads in the skin, then the priest shall pronounce him unclean; it is diseased. 23 But if the spot remains in one place and does not spread, it is the scar of the boil; and the priest shall pronounce him clean.
24 “Or, when the body has a burn on its skin and the raw flesh of the burn becomes a spot, reddish-white or white, 25 the priest shall examine it, and if the hair in the spot has turned white and it appears deeper than the skin, then it is leprosy; it has broken out in the burn, and the priest shall pronounce him unclean; it is a leprous disease. 26 But if the priest examines it, and the hair in the spot is not white and it is no deeper than the skin, but is dim, the priest shall shut him up seven days, 27 and the priest shall examine him the seventh day; if it is spreading in the skin, then the priest shall pronounce him unclean; it is a leprous disease. 28 But if the spot remains in one place and does not spread in the skin, but is dim, it is a swelling from the burn, and the priest shall pronounce him clean; for it is the scar of the burn.
29 “When a man or woman has a disease on the head or the beard, 30 the priest shall examine the disease; and if it appears deeper than the skin, and the hair in it is yellow and thin, then the priest shall pronounce him unclean; it is an itch, a leprosy of the head or the beard. 31 And if the priest examines the itching disease, and it appears no deeper than the skin and there is no black hair in it, then the priest shall shut up the person with the itching disease for seven days, 32 and on the seventh day the priest shall examine the disease; and if the itch has not spread, and there is in it no yellow hair, and the itch appears to be no deeper than the skin, 33 then he shall shave himself, but the itch he shall not shave; and the priest shall shut up the person with the itching disease for seven days more; 34 and on the seventh day the priest shall examine the itch, and if the itch has not spread in the skin and it appears to be no deeper than the skin, then the priest shall pronounce him clean; and he shall wash his clothes, and be clean. 35 But if the itch spreads in the skin after his cleansing, 36 then the priest shall examine him, and if the itch has spread in the skin, the priest need not seek for the yellow hair; he is unclean. 37 But if in his eyes the itch is checked, and black hair has grown in it, the itch is healed, he is clean; and the priest shall pronounce him clean.
38 “When a man or a woman has spots on the skin of the body, white spots, 39 the priest shall make an examination, and if the spots on the skin of the body are of a dull white, it is tetter that has broken out in the skin; he is clean.
Tetter is an archaic term, which the dictionary says refers to eczema or ringworm. Eczema is not contagious but ringworm -- actually a fungal infection -- is. But neither of them is dull white, both are reddish.
40 “If a man’s hair has fallen from his head, he is bald but he is clean. 41 And if a man’s hair has fallen from his forehead and temples, he has baldness of the forehead but he is clean. 42 But if there is on the bald head or the bald forehead a reddish-white diseased spot, it is leprosy breaking out on his bald head or his bald forehead. 43 Then the priest shall examine him, and if the diseased swelling is reddish-white on his bald head or on his bald forehead, like the appearance of leprosy in the skin of the body, 44 he is a leprous man, he is unclean; the priest must pronounce him unclean; his disease is on his head.
45 “The leper who has the disease shall wear torn clothes and let the hair of his head hang loose, and he shall cover his upper lip and cry, ‘Unclean, unclean.’ 46 He shall remain unclean as long as he has the disease; he is unclean; he shall dwell alone in a habitation outside the camp.

Saturday, April 18, 2020

A second historic failure of leadership

That's how Ed Pilkington and Dominic Rushe put it in The Guardian. The first historic failure was of course the six weeks or more of dithering, delay and denial in February and March that left us in this catastrophic situation. Yes, the Resident was not the only politician who spent time in denial but whataboutism doesn't relieve him of blame, especially since he was briefed repeatedly on the urgent danger of the situation and he rejected what experts were telling him out of hand.

The first cases were reported in the U.S. and South Korea on the same day.

One country acted swiftly and aggressively to detect and isolate the virus, and by doing so has largely contained the crisis. The other country dithered and procrastinated, became mired in chaos and confusion, was distracted by the individual whims of its leader, and is now confronted by a health emergency of daunting proportions.
Within a week of its first confirmed case, South Korea’s disease control agency had summoned 20 private companies to the medical equivalent of a war-planning summit and told them to develop a test for the virus at lightning speed. A week after that, the first diagnostic test was approved and went into battle, identifying infected individuals who could then be quarantined to halt the advance of the disease.
The result? As of today the U.S. has reported 37,175 deaths from Coronavirus, that is 112 per million population, which is a substantial undercount. South Korea has reported 232 deaths, 5 per million, which is probably fairly accurate. And they never had to impose the same level of extreme restrictions that we have.

The problem we now face, of how to ease restrictions and move toward more normal social and economic activity, is the same problem but now on a much larger scale. We need the capacity to test millions of people for infection so that we can trace contacts of people who turn up sick and quarantine those who are infected.  We are nowhere near that capacity. As former CDC Director Tom Frieden puts it, “I fear there’s an analogous mistaken belief that sheltering in place will make this virus go away, that we can then choose a date and all come out. It’s not about the date, it’s about data and building a national response at scale.

While the Resident continues to publicly insist that the U.S. has excellent testing capacity, in fact not one of the states is in a position to adequately trace and test contacts. The federal government is doing nothing to increase testing capacity, and forcing the states to compete with each other for what resources exist. Democratic Senators did a conference call with the VP and came away furious at the total abdication of responsibility.

Sen. Angus King, Maine's independent who caucuses with Democrats, reportedly called the administration's response to the crisis, particularly the failure to get testing ramped up, a "dereliction of duty." According to sources on the call, he told Pence, "I have never been so mad about a phone call in my life." After the call, he "was still very angry" when interviewed by Washington Post reporter Seung Min Kim, telling her "I can't discern a national strategy (for testing) ... I can't even discern what the goal is."
"The fundamental problem is a lack of capacity which at this point they can't fix," a Democrat on the call told Politico. "So they are explaining it away. […] Everyone was livid." They still are. "The Trump administration doesn't even have a target for the number of tests we need to be able to manage this health care crisis. It's beyond unbelievable," Sen. Elizabeth Warren told Boston Globe reporter Jess Bidgood.

Instead of exercising leadership and providing the resources needed to address the crisis -- which the administration could do right now using the Defense Procurement Act - the Resident is fomenting insurrection. Since a very large majority of people in the states he is targeting for armed rebellion support their governors' policies, the definition of "liberation" appears to be rule by a small mob of armed thugs.

Yes, there is a legitimate discussion to be had about the costs and benefits of specific measures. How restrictive should we be in a given place and time? We do need to find ways of allowing economic recovery and giving people more freedom. But that has to be a rational discussion based on facts, and by far the best way to get to a more sustainable situation is to develop the necessary tracing and testing capacity. Instead, we have a conservative movement that has gone batshit insane.

Thursday, April 16, 2020

Now it's personal

My mother is in a nursing home. One of the residents tested positive. As you probably know, nursing home right now are extremely dangerous places for both residents and workers, and  account for a large percentage of deaths in most states.

So naturally I assumed the first thing they would do is to test all the residents and staff and determine if there are any other infections. Nope. No. Not going to happen. They will only test people who become symptomatic.

Can you spot the problem with that? As you should also know by now if you have crawled out from under your rock lately, people without symptoms can be infectious. Ergo there could be 1 or 6 or 10 other people in that nursing home right now who are infecting others. Including my mother.

Why can't they test them? Because there aren't enough testing kits in Connecticut to test people who aren't symptomatic. This goes back to the beginning. We wouldn't be in such a profound crisis if the federal government hadn't bungled the ramp up of testing capacity in the first place.

[A]s the deadly virus spread from China with ferocity across the United States between late January and early March, large-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels, according to interviews with more than 50 current and former public health officials, administration officials, senior scientists and company executives.
The result was a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.

And how are we going to get out of this? First, we need to be able to test a large population based sample in every part of the country to understand the current prevalence and what percentage of people turn up sick and actually get diagnosed. Then we need to have enough testing capacity to trace and test the contacts of people who are determined to be infected. Only then can we relax the lockdown and start to get back to some semblance of  normalcy. But we can't do that because we don't have the testing capacity. Right now, we can't even prevent outbreaks in nursing homes where we know people have been exposed. That's the story.

Tuesday, April 14, 2020

When life hands you lemons . . .

and then crab apples, and you don't have any sugar, you ain't making lemonade. My power went out at 1:30 yesterday and didn't come back on until 2:30 today. Being unable to charge my devices, I deprived you all of the blog posts you so desperately wanted. I had two very important phone meetings and some other business so I hoarded my batteries. Didn't really have anything to eat to speak of the whole time and had to spend my evening reading by flashlight.

Oh, boo hoo, poor man. I'm not sick, nobody I know has gotten sick from this, and Windham County has so far largely been spared. The power outages are indeed becoming more frequent and that will get worse. The Gulf of Mexico is the warmest it's ever been and that's why we had a storm of tropical storm intensity over a vast area that spawned tornadoes that killed people and knocked down trees that took out power across much of the country east of the Mississippi. It will keep happening. But we're rich and we can put the wires back up.

But, as The Editorial Board points out, we have yet to hear from the refugee camps, the failed states, the regions of civil conflict, the poor nations with minimal health care infrastructure, the slums of Mumbai. This has actually puzzled me. I'm pretty sure the numbers coming out of Iran are bogus, and Iraq has a barely functioning government and public health infrastructure but reports cases and deaths by the single digits. It seems that can't be true, but a widespread outbreak ought to be very hard to hide. A tell is that the numbers coming out of Iraqi Kurdistan, which does have a functioning government, are higher, but they also had a substantial response. I expect we'll be hearing more of the truth from Iraq and Syria, Turkey and Russia, very soon.

This is very disturbing but keep in mind that unlike the medieval Europeans who were decimated by the Black Death, we understand what's happening and we know what to do about it. We can come out of this with a better world, despite the terrible losses, but only if the people and leaders can exercise wisdom that has been sorely lacking so far.

Sunday, April 12, 2020

Sunday Sermonette II: Jesus Christ . . .

So the idea is that all humans were tainted by sin because Eve ate the apple, so nobody could go to heaven when they died. Eight thousand years or so later (depending on your accounting) God decided to do something about it by killing his son, who was also himself. Since God can't die he didn't actually die after all. And now you can go to heaven, if and only if you believe this crap.

Every year Christians have a big celebration of this absurd tale, and many people go to church who don't bother most other weeks. This year in many states they aren't allowed to, but some pastors are doing it anyway, and in some states with Republican governors it's even legal. It isn't legal in Louisiana, which has a severe outbreak of a sometimes deadly contagious disease, but this asshole is having his church service anyway. The Trump Mini-me governor of Florida, Ron deSantis, has now declared church services to be legal after all, and a mega-church pastor in Tampa is having one.

No, the First Amendment doesn't let you do that. Religious practices are subject to the same public health and safety regulations as all other activities. You can't discriminate against religion, but it doesn't get special privileges either. If my religion requires human sacrifice, I don't get to practice it. Just for example. If people want to make themselves candidates for Darwin awards by attending these, that would be fine with me except that they are also imperiling other people. Not only will they likely sicken and perhaps kill people who didn't make this choice, they will delay the time when it is possible to relax restrictions, further harming the economy and the general welfare. All in the name of Jesus.

Sunday Sermonette: Motherhood is Icky

If you thought all the instructions for killing and burning animals were weird, you ain't seen nothing yet. We are now getting into the weirdest part of Leviticus, as far as I'm concerned. Chapter 12 is very short, but the next two are quite possibly the longest in the Bible, so I'll have to take them 1/2 at a time. This one is among the shortest, but it requires some exegesis. Why would a new mother be "unclean" and require "purification"? Why must she make a sin offering? Is childbirth a sin?

I've read some commentary on this. It turns out that some form of purification ritual after childbirth was ubiquitous in ancient religions. But as with animal sacrifice, I can't find any convincing explanation as to why. What this chapter literally seems to say is that the uncleanness has to do with blood. Childbirth is a messy process that involves some discharge of blood, as does menstruation, so they are treated similarly. (The book will get to menstruation later.) Blood, as we have seen, is something of an obsession. It's sacred when smeared on the altar or the priests' toes and ears, but otherwise abhorrent.

Note that there is a difference between the one or two week period of "uncleanness," and the more extended period of purification. The text defines "uncleanness" in this context as equivalent to the requirements for menstruation, which means quarantine. Of course she needs to have the baby with her. Maybe it's okay for grandma to help out? But why the different length of time for baby girls and baby boys? Are girls ickier?

What is happening during the more extended period of "the blood of her purifying?" And why that odd turn of phrase?  I haven't been able to find an explanation. Again, no good explanation for the double period for girl babies. And, while the burnt offering could be seen as a symbol of gratitude God for the new baby, the sin offering has unclear implications. Apologists come up with various metaphorical explanations for all this but if you can read anything into it you like, it doesn't actually mean anything, as far as I'm concerned.

12 The Lord said to Moses, “Say to the people of Israel, If a woman conceives, and bears a male child, then she shall be unclean seven days; as at the time of her menstruation, she shall be unclean. And on the eighth day the flesh of his foreskin shall be circumcised. Then she shall continue for thirty-three days in the blood of her purifying; she shall not touch any hallowed thing, nor come into the sanctuary, until the days of her purifying are completed. But if she bears a female child, then she shall be unclean two weeks, as in her menstruation; and she shall continue in the blood of her purifying for sixty-six days.
“And when the days of her purifying are completed, whether for a son or for a daughter, she shall bring to the priest at the door of the tent of meeting a lamb a year old for a burnt offering, and a young pigeon or a turtledove for a sin offering, and he shall offer it before the Lord, and make atonement for her; then she shall be clean from the flow of her blood. This is the law for her who bears a child, either male or female. And if she cannot afford a lamb, then she shall take two turtledoves or two young pigeons, one for a burnt offering and the other for a sin offering; and the priest shall make atonement for her, and she shall be clean.”

Friday, April 10, 2020

A righteous rant

David Frum is a neocon who was, among other disgraces, a speechwriter for George W. Bush, ardently supported the invasion of Iraq and even worked for Rudy Giuliani's ill fated presidential campaign. So he's unforgivable. But even he has the wit to see the White House occupant for the witless narcissistic buffoon he is. And yes, the disaster has fallen upon us because of his utter unworthiness for the office he holds and the bottomless well of his vanity. This is long because it is an exhaustive bill of particulars. If you wish to comment, you must read the whole thing. That is all.b

Update: Some people's brains are falling out. David Frum is a wingnut conservative Republican. That is specified in the first sentence of the above post. He isn't "politicizing" the crisis, he is reciting a litany of facts, in direct contravention of his wingnut conservative political interests. The concrete skulls of cult followers are obviously impenetrable by any combination of facts and logic. .Your brain has stopped functioning. You should check into a mental hospital.

Thursday, April 09, 2020

And here's a good long form . . .

discussion of the undercount of Covid deaths. And no, death certificates aren't going to let us get a true final tally. They are an excellent example of the reification of data. The cause of death may be given as pneumonia, or even just respiratory arrest, or it may be attributed to some comorbidity and the contribution of the virus to the death may not be noted. Doctors aren't trained to fill these out in any particular way and again, if the person doesn't have laboratory confirmed Covid-19 it will very likely not be on the death certificate even if everybody knows that's almost certainly what it was.

Outside of the U.S., in countries  with no adequately functioning public health system, we aren't getting any kind of useful count at all.

Update: Just to clarify, in response to a comment (I'm lifting this to the front page) part of the problem is that cause of death is often ambiguous. People have multiple morbidities. If someone who is otherwise not healthy gets finished off by flu or Covid, what do you put on the death certificate? It's a judgment call. The viral infection likely caused death sooner than it otherwise would have occurred, but heart disease or whatever is also a contributing cause. Doctors don't attribute death in a consistent way, and it's also a philosophical conundrum. After all we are all mortal and our life expectancy declines as we get older. You can't actually save anybody's life, you can only prolong it. How long is enough to matter is imponderable.

The reification of data

Every day you are reading reports of the number of new Covid cases and deaths in your state, the U.S., other countries and the whole world. You need to know that these numbers are false. They may give an indication of trends, but they are not the actual number of cases and deaths.

Let's start with cases. The definition of a "case" can vary, but for the most part the numbers you see are the number of positive PCR tests. This is obviously a function of how many people get tested and the sampling frame for those tests. Right now in the U.S. we are not testing a random sample of the population anywhere. We are largely only testing people who present with severe enough symptoms to consider hospitalization, and some other situations such as the residents of nursing homes with a positive case. What we ought to be doing is what South Korea started doing from the beginning: testing all the contacts of known cases so that people who tested positive could be isolated. That's how they got control of the epidemic early, but it's far too late for that in the U.S. Therefore we actually have no idea how many people in the U.S. are, or have been infected.

There's another problem. The test we're using in the U.S. is not very sensitive. The best estimate is that it's 70% sensitive which means that nearly one third of people who are in fact infected will test negative. In much of the world, there is even less capacity to test and in many places people who get sick don't even get medical care. The actual toll in places like Iran, Iraq, Syria, Yemen, is completely unknown but absolutely must be far higher than what has been reported.

As for deaths, countries have different capacities and policies for counting them. For the most part only deaths in hospitals are reported, and only counted if the person had tested positive -- this is  the case in both the U.S. and the U.K. But many people never make it to the hospital and some who do are never tested.

The daily tally of New York City residents who died at home with coronavirus-like symptoms exploded from 45 on March 20 to 241 on April 5, according to Fire Department of New York data - suggesting the city may be significantly undercounting COVID-19 deaths.. . .

And Alabama:

When patients arrive in the emergency room with trouble breathing, doctors may not know for sure if they have coronavirus. If those patients pass away, their families are no longer in the emergency room to help doctors understand the back story.
“I'm never going to know, because I'm not going to test them in arrears and we generally don't do autopsies on these deaths,” she said. . . .
For physicians on the frontlines facing uncertainty about what’s ahead, like Dr. Williams in Huntsville, having some idea of a death rate for the disease is helping her team prepare for what may come. She says she has read guidance from the CDC, which collects cause of death data from states, asking physicians to note “probable” or “presumed” COVID-19 deaths. But as a healthcare professional, she says she is not comfortable with that level of guessing, and the online death certificates she uses don’t give a “probable” option. “We tend to not want to put things that we can’t know for sure,” she said, adding that there’s a variable practice among doctors.
And it's worse than that. As Josh Marshall reports: 

We’ve now seen the common pattern. A certain region or jurisdiction reports X number of COVID-19 fatalities over a given period. But when the average number of deaths for all causes is compared to these COVID-19 death tolls they are still dramatically higher than the COVID-19 numbers alone can account for. So we see a large number of unexplained deaths that are almost certainly due to the COVID-19 crisis, whether that is people dying of COVID-19 or dying from other causes at higher rates because of the social and medical care disruptions brought in its wake.

He goes on to discuss the example of Madrid:

The basic numbers. In 2019 they estimate there were 2,394 deaths between March 14th and March 31st in the Madrid region. In 2020 that number was 9,007. So a difference of 6,613. But the number of official COVID-19 deaths during that period was 3,439. So simple math, 3,174 unexplained deaths.

So will we ever know anything close to the truth? We'll probably come up with reasonably good estimates after the fact, but we aren't being told the truth in real time.


Tuesday, April 07, 2020

The Death Cult

Chauncey DeVega interviews Steve Hassan, a cult expert with personal experience. (He was a Moonie.) It's definitely worth your while to read the whole thing. He explains how cults of personality work and why Trump cultists are impervious to facts or logic. For those of us on the outside, it seems incomprehensible how this repulsive, stupid, malicious, narcissistic pathological liar, bully and coward can possibly attract the admiration of anyone or find anyone to believe the constant flow of bullshit out of his mouth. To Hassan, it seems, it's no mystery. I'll give you a taste, but you have to read it.

Donald Trump fits the stereotypical profile of all destructive cults. These traits include malignant narcissism. Trump can easily be compared to Jim Jones, Sun Myung Moon, and other cult leaders. Trump always had a cult of personality around him in terms of his businesses and his social interactions with people. But once Trump attained the presidency, he took over the Republican Party and instituted a fiefdom where he rewards loyalty and punishes anyone who displeases him.
As for definitions, a "destructive cult" is an authoritarian pyramid-structured group with someone at the top who claims to know all things and says God is working through him or her. Trump does that as well. Donald Trump is also trying to control people's behavior, the information they have access to, and their thoughts and emotions, to make them dependent and obedient and under his control. Consider the novel coronavirus pandemic and how Trump has all these followers who do not trust real experts and only take what Trump says to be true. Trump's followers also don't believe in science and medicine.  

Monday, April 06, 2020

Why we do clinical trials

We've all gotten sick of the Resident's constant boasting about the greatness of his intellect. Axios has a roundup compiled in January. It's too long to reproduce, but highlights include:

ISIS: "I know more about ISIS than the generals do." (November 2015.) 
Trade: "Nobody knows more about trade than me." (March 2016.)
The U.S. government system: "[N]obody knows the system better than I do." (April 2016.) Renewable energy: "I know more about renewables than any human being on Earth." (April 2016.) Taxes: "I think nobody knows more about taxes than I do, maybe in the history of the world." (May 2016.) 
Infrastructure: "[L]ook, as a builder, nobody in the history of this country has ever known so much about infrastructure as Donald Trump." (July 2016.
The economy: "I think I know about it better than [the Federal Reserve]." (October 2018.)
Technology: "Technology — nobody knows more about technology than me." (December 2018.)
Drones: "I know more about drones than anybody. I know about every form of safety that you can have." (January 2019.)
Since then among other grandiosity, there was his notorious visit to CDC headquarters.

“I like this stuff. I really get it,” Mr Trump boasted to reporters during a tour of the Centers for Disease Control (CDC) and Prevention in Atlanta, where he met with actual doctors and scientists who are feverishly scrambling to contain and combat the deadly illness.
Citing a “great, super-genius uncle” who taught at MIT, Mr Trump professed it must run in the family genes. “People are really surprised I understand this stuff,” he said. “Every one of these doctors said: ‘How do you know so much about this?’ Maybe I have a natural ability.” . . . Sporting his trademark red 2020 campaign hat with the slogan “Keep America Great”, the president repeatedly second-guessed and waved off the actual medical professionals standing next to him.

Well, we can add pharmacy to that list.  Abetted by his trade representative, who somehow has managed to worm his way into coronavirus task force meetings, he "knows" the hydroxychloroquine is the miracle cure. He has decided to order Anthony Fauci to shut up about it.

Well I may or may not be a stable genius, but I do happen to know more about this stuff than he does. There has never been a single controlled clinical trial of the drug for coronavirus. And while it has shown activity against other viruses in vitro and in animals, clinical trials in humans have all been failures. All that has happened so far is that doctors have given it to some patients and observed that some of the patients got better.

Well yeah. Most people do get better if you give them M&Ms. This happens all the time. Doctors or uncredentialed cranks give people their pet miracle cure and decide that it works. 99% of the time, no it doesn't. That's why we do placebo-controlled randomized trials. There are many reasons people can fool themselves. As I say, most people get better on their own. You want it to work so you're inclined to see an effect, but you aren't actually comparing it to anything so your bias leads you to a false conclusion. Also, too, most drugs -- including this one -- can have serious adverse effects so you need to make sure that the benefits, whatever they may be, justify the risk. And this stuff can kill you.

I think it's very unlikely that it has much value, if any. But I do know one thing for sure. Anthony Navarro and Ronald T. Dump have no fucking idea what they are talking about and they may do enormous harm by their ignorant claims.

Sunday, April 05, 2020

Sunday Sermonette: You are what you eat

Now we come to a part of Leviticus which is still in effect for observant Jews. I've done a bit of reading to find out how people have tried to explain the origin of the dietary laws, but I'm not going to give any links because nobody has a very good idea. Some have attempted to explain them as actually being hygienic, i.e. that there is a legitimate public health rationale to them, but obviously there is not. It is true that pork can harbor a parasite called trichinosis, but ruminants can also harbor parasites and they're all destroyed by cooking. Cultures that eat pig meat obviously don't have a problem. The best idea anybody has come up with is that it's basically just a way of enforcing identity. It's difficult to commingle much with your neighbors if you can't eat their food. Today, even many non-observant Jews follow at least a relaxed version of the dietary laws as a sign of ethnic identity. Since the Israelites started off as a pastoral culture they generally ate ruminants and not pigs anyway, so it wasn't much of a sacrifice. Some of the other prohibitions and exceptions, however, are not so easy to explain. Also, Leviticus 11 demonstrates that God has a woeful understanding of biology. He doesn't know anything about many of the creatures he created.

11 And the Lord said to Moses and Aaron, “Say to the people of Israel, These are the living things which you may eat among all the beasts that are on the earth. Whatever parts the hoof and is cloven-footed and chews the cud, among the animals, you may eat. Nevertheless among those that chew the cud or part the hoof, you shall not eat these: The camel, because it chews the cud but does not part the hoof, is unclean to you. And the rock badger, because it chews the cud but does not part the hoof, is unclean to you. And the hare, because it chews the cud but does not part the hoof, is unclean to you.
Err, no. Badgers and hares do not chew the cud. 
And the swine, because it parts the hoof and is cloven-footed but does not chew the cud, is unclean to you. Of their flesh you shall not eat, and their carcasses you shall not touch; they are unclean to you.
“These you may eat, of all that are in the waters. Everything in the waters that has fins and scales, whether in the seas or in the rivers, you may eat. 10 But anything in the seas or the rivers that has not fins and scales, of the swarming creatures in the waters and of the living creatures that are in the waters, is an abomination to you. 11 They shall remain an abomination to you; of their flesh you shall not eat, and their carcasses you shall have in abomination. 12 Everything in the waters that has not fins and scales is an abomination to you.

13 “And these you shall have in abomination among the birds, they shall not be eaten, they are an abomination: the eagle, the vulture, the osprey, 14 the kite, the falcon according to its kind, 15 every raven according to its kind, 16 the ostrich, the nighthawk, the sea gull, the hawk according to its kind, 17 the owl, the cormorant, the ibis, 18 the water hen, the pelican, the carrion vulture, 19 the stork, the heron according to its kind, the hoopoe, and the bat.
God thinks that bats are birds. I'm not sure why NIV has "water hen," KJV has "swan." Most of these species are not commonly eaten, except for the ostrich and the swan. But this prohibition seems entirely arbitrary. 
20 “All winged insects that go upon all fours are an abomination to you. 21 
Sine God created the insects you might think he would know how many legs insects have. 
Yet among the winged insects that go on all fours you may eat those which have legs above their feet, with which to leap on the earth. 22 
He got, feet down below his knees . .  .
Of them you may eat: the locust according to its kind, the bald locust according to its kind, the cricket according to its kind, and the grasshopper according to its kind. 23 But all other winged insects which have four feet are an abomination to you.
At least I can think of an explanation for this. Locusts can wipe out crops, so you might not have anything else to eat. But insects with four feet are pretty rare.

24 “And by these you shall become unclean; whoever touches their carcass shall be unclean until the evening, 25 and whoever carries any part of their carcass shall wash his clothes and be unclean until the evening. 26 Every animal which parts the hoof but is not cloven-footed or does not chew the cud is unclean to you; every one who touches them shall be unclean. 27 And all that go on their paws, among the animals that go on all fours, are unclean to you; whoever touches their carcass shall be unclean until the evening, 28 and he who carries their carcass shall wash his clothes and be unclean until the evening; they are unclean to you.
Not clear what it means to be "unclean until the evening." It isn't spelled out but I guess it means other people aren't supposed to touch you?
29 “And these are unclean to you among the swarming things that swarm upon the earth: the weasel, the mouse, the great lizard according to its kind, 30 the gecko, the land crocodile, the lizard, the sand lizard, and the chameleon. 31 These are unclean to you among all that swarm; whoever touches them when they are dead shall be unclean until the evening. 32 And anything upon which any of them falls when they are dead shall be unclean, whether it is an article of wood or a garment or a skin or a sack, any vessel that is used for any purpose; it must be put into water, and it shall be unclean until the evening; then it shall be clean. 33 And if any of them falls into any earthen vessel, all that is in it shall be unclean, and you shall break it. 34 Any food in it which may be eaten, upon which water may come, shall be unclean; and all drink which may be drunk from every such vessel shall be unclean. 35 And everything upon which any part of their carcass falls shall be unclean; whether oven or stove, it shall be broken in pieces; they are unclean, and shall be unclean to you. 36 
This would produce an awful waste of goods, if followed strictly.
Nevertheless a spring or a cistern holding water shall be clean; but whatever touches their carcass shall be unclean. 37 And if any part of their carcass falls upon any seed for sowing that is to be sown, it is clean; 38 but if water is put on the seed and any part of their carcass falls on it, it is unclean to you.
39 “And if any animal of which you may eat dies, he who touches its carcass shall be unclean until the evening, 40 and he who eats of its carcass shall wash his clothes and be unclean until the evening; he also who carries the carcass shall wash his clothes and be unclean until the evening.
41 “Every swarming thing that swarms upon the earth is an abomination; it shall not be eaten. 42 Whatever goes on its belly, and whatever goes on all fours, or whatever has many feet, all the swarming things that swarm upon the earth, you shall not eat; for they are an abomination. 43 You shall not make yourselves abominable with any swarming thing that swarms; and you shall not defile yourselves with them, lest you become unclean. 44 For I am the Lord your God; consecrate yourselves therefore, and be holy, for I am holy. You shall not defile yourselves with any swarming thing that crawls upon the earth. 45 For I am the Lord who brought you up out of the land of Egypt, to be your God; you shall therefore be holy, for I am holy.”
46 This is the law pertaining to beast and bird and every living creature that moves through the waters and every creature that swarms upon the earth, 47 to make a distinction between the unclean and the clean and between the living creature that may be eaten and the living creature that may not be eaten.